Each point of consensus includes recommendations and action items around policy, research and features to embed in federal demonstration projects. Some require development of new structures for measurement and evaluation, but others build upon existing efforts, such as aligning federal meaningful use standards with health IT requirements associated with medical home recognition and ACO regulations. The group will continue to work together in support of these shared goals.
"This report indicates that key stakeholders are in agreement on the need to promote patient-centered, coordinated care through changes in the way we pay for and deliver care, and development of medical homes and accountable care organizations are mutually reinforcing models for achieving these goals," said Commonwealth Fund President Karen Davis.
Of the four value-driving elements identified, two -- enhanced access and care coordination -- require urgent overhaul to maximize health outcomes at lower costs. The others, HIT and payment reform, are essential tools without which widespread implementation of new care delivery models will not succeed, the report said.
Better to Best lays the groundwork for achieving the Triple Aim: Improve the health of the population; enhance the patient experience of care; and reduce, or at least control, the per capita cost of care, said co-author Elliott S. Fisher, MD, in a statement. Fisher is a leading proponent of the ACO concept. "If we remain true to the agreement made in September and formalized in this document, we have the opportunity to help create an accountable, patient-centered system that not only enhances quality of patient care but controls costs."
The report may be downloaded here.
On Thursday, the Department of Health and Human Services unveiled long-awaited proposed regulations for ACOs.